Sometimes these ponderings will be from Caunes, and sometimes from Yorkshire.

Saturday, 3 October 2015

Examen normal

I need to start this post with stating that I cannot envisage life with out our amazing NHS.

The NHS saved my life 3 years ago, and continues to keeps its careful eyes on me. I have been lucky enough to experience the NHS at its very best, where it leaps into action, saving lives, providing absolutely, the best treatment and care, and doing it brilliantly.

I will always defend it, always wanting the concept of equality of service, available to everyone, free at the point of delivery....always, always.

In this post I want to describe how I have recently experienced the health system in France.

On Tuesday this week, I visited a local GP in our village. I had been experiencing some pain in my side as it hadn't disappeared after a few days of ibuprofen/paracetamol treatment. I am very anxious about pain, after my cancer experience, and had started to lose sleep, imagining the worst. My cancer was an aggressive strain, and I know I am lucky to be alive. The thought of its return is never too far from my mind.

So, at 5.15pm on Tuesday, I saw the GP. I did have to wait in her no appointments surgery for quite a while, but I saw her, on the day I decided I needed to see a Dr.

I spent half an hour with her, talking, being listened to, being examined and then discussing with her, what it might be. As far as she was concerned there was no question that I needed blood tests, an X ray and a scan to check things out, due to my cancer history.

The next morning, a local nurse came to my house, before breakfast, to take the blood. I was informed that I would get the results the following morning, by priority mail. I did, and they indicated there was no problem.

I had to telephone the hospital to arrange the X ray and scan, which I was able to do for the following day.

At 5.00pm, 48 hours after seeing the GP, I was called into the X ray dept, 15 minutes later I was led into the scan department by the Dr who discussed the X ray results with me, as she set up the scanning equipment. 20 minutes later, I left the scan department having been told there was no problem. No cancer, no unexplained masses.......a bit of ageing of the bones possibly, but most importantly, the scan had showed up nothing of any significance.

I left the hospital an hour after arriving, 49 hours after having first seen the GP, holding a copy of my X ray, a copy of my scan and a copy of the Consultant's report on the scan.

I have to add that I also carried with me the receipt for the bill I had just paid. I have an interesting collection of receipts and bills now..... 23 euros for the GP consultation, 8 euros for the nurse's visit, 38 euros for the lab work on the blood tests and 176 euros for the X ray, the scan and the Consultant's time.

The stack of bills

I can claim most of that back through the European Health card system, but to be honest, it feels like the best 200+ euros I've ever spent. Within 48 hours, any panic I had felt, was gone.

The pain.....probably nerve damage from my surgery and from chemo...possibly some scar tissue......all of which can be coped with, and medicated for if required.

The outcome would have been the same in the UK. I do not have cancer.....but it would have taken considerably longer to calm my nerves. I actually haven't had a scan in the UK since I ended my chemotherapy, two and a half years ago. When I have questioned this, the response has always been that there is no need, if there seems to be no problem. Reassurance scans are not something that our beloved NHS is fond of.

So....panic over, normal sleep patterns resumed.

I am not saying this is better than the NHS. It is different, and I do not know how it works. I know that there are schemes to ensure that people who earn less do not have to pay, and that those who earn more, pay for "top up " insurance. They do not hand over piles of cash when they received their bills from each stage of the process. They hand over their insurance details.

What I cannot fathom, is how it works so efficiently.

How can I get a Drs appointment on the evening that I decide I want one ? How can I have a nurse come to my house 15 hours after it is determined I need a blood test ? How can I get a scan appointment within 24 hours ? How can I be called for my scan appointment at exactly the time I booked ? How can I get the results immediately, and take away the hard copy evidence of my " examen normal " ?

This was a good experience. I can go to my next NHS check up armed with a scan, a report and a stack of blood test results indicating "all is well ".

I really don't know how I feel about all of this. I want the values of the NHS, the principles of the NHS, the quality of the care provided by the NHS.......but I also want the speed and efficiency that I have experienced here in France.

21 comments:

Excellent service and very much like my experiences of the Turkish health system. I can walk into a hospital here without an appointment, see a doctor, have ultrasounds, blood and urine tests and anything else deemed necessary, collecting the results of tests along the way without spending more than a maximum of half a day in the hospital. The hospitals are always crowded but somehow the system works and everyone is seen and treated fast and efficiently. I wish I had your faith in the NHS these days but I don't because of experiences my daughter has had over the past couple of years. Cutbacks have meant that she doesn't get a check-up that was deemed necessary when she first saw a specialist..now she has to wait very much longer. I'm so glad to hear that your results show that everything is good xxx

As you can imagine, I am quite relieved. It has caused me to wonder why on earth the NHS can't organise specialist diagnosis more quickly. Once I was in the system 3 years ago, things moved very quickly, and I know I received world class treatment and follow up care. However, I had a dreadful time insisting on cancer marker tests when the GP I was seeing told me I was more likely to be diabetic than have cancer.... 2 weeks later I was diagnosed with stage 4 aggressive cancer ! Some bits of the NHS are stunningly good. My treatment would have cost hundreds of thousands of dollars in the US, and of course, we just take it for granted that it is there, ready for us when we need it. Altogether, needing to access the services here in France has been food for thought. It does feel strange passing the 23 euros over to the GP after the consultation ( especially when she reaches for the 2 euros change from a little pot jug she keeps on her shelf ! ) Talking to friends who still work in the NHS, where I worked for the last 3 years before I retired, I know how frustrated they feel at the cutbacks, while they soldier on, desperately trying to maintain the high standards they want to, and that they know is what it should be.

If I have a blood test in Turkey, I get the result the same or next day, My mother in England waits for 2 weeks. If I have my eyes tested in Turkey, I get my new glasses that day, my mother waits for at least a week. Last year, when my father felt dizzy and passed out, he was taken into hospital, they told him he needed tests and would stay over night but at 10 pm that same day, they told him he had to go home, (an 88 yr old finding his own way late at night} and his GP would contact him for tests the next week. 24 hours later, he died of a massive heart attack. I think the NHS should look abroad and see how its neighbours act. Yes they are great in an emergency but a lot of people fall through the many holes in the net.

Your father's story is so awful. There are just too many holes, and a service that can only operate as a net rather than something working at prevention of problems in the first place rather than just responding to them, needs a serious overhaul.

Dear Janice - I can imagine how your mind must go into overdrive when something different happens in to your body, but thank goodness the result was 'Examen normal', and that it all well and quickly resolved for you.I am not really in a position to talk about the NHS - touch wood, something that I am happy to steer clear of for as long as I possibly can.

The simple answer is that France spends a greater proportion of GDP on healthcare than we do in the UK (11.9% as against 9.6% in 2011, the latest figures I can find.) In the past the French health service has been amazingly well supplied with staff and equipment, with even small town hospitals (pop. 20,000+) having their own MRI scanner in our area. But things are changing as cuts bite and this summer I read reports in our local press of services being amalgamated at fewer centres for efficiency and economy and also because they couldn't recruit sufficient staff.

I'm so glad the tests proved negative and your mind was put at rest so quickly, but the only way this would be possible in the UK without going privately is by funding being increased very, very markedly, which doesn't look likely as things stand. :(

GPs at gatekeepers seems to be one of thestumbling blocks as far as I can see. There clearly aren't enough of them....but referring on does not seem to come naturally to some of them, or at least, that has been my experience. Arguing with a GP about getting a cancer marker blood test, 2 weeks before my stage 4 cancer diagnosis will remain in my mind forever....she did not want to let me have the test, as in her view I was being paranoid ! Obviously, overall funding is the main problem, as you say...but there do seem to be some real organisational blocks within the system in the UK. I saw the article you shared ( I think it was you!) on face book, about GPs being paid to cut their referrals.....this is scary stuff.

Why can't the radiologist ( who has studied for years, and is a real expert) talk to the patient about what they can see on the X ray they have just taken ? Why do we have to wait days/weeks for the radiologist to send a report to the Consultant, for them to interpret, before their secretary pencils you in for a clinic 2 weeks later, ( if you're lucky ) to discuss the results ?

I am the greatest supporter of the NHS, and I hate it that this sentence sounds as if a "but" is coming. I just desperately want it to be world class, and to fix all those holes in the net that we hear about so frequently.

As you can imagine, the speed in which I received diagnostic work this week, has given me great peace of mind....just as happened a few months ago when I phoned my fabulous specialist nurse contact in Halifax, and she arranged an appointment with my Yorkshire Consultant for the following day. It can be done....and I have been so lucky, because I know it doesn't always work like that.

I'm sorry you've found your GP uncooperative in the past, Janice, as my experience has been very different. When I found my first breast lump, my GP swung into action and got me the first possible appointment at the weekly breast clinic in Shrewsbury. I've had similar rapid action when it came to referrals for cataract surgery and other things, but I agree that the delays in interpretation of X-rays and scans by consultants often seems unreasonable. They can do this immediately when it's a case of trauma, such as my broken wrist, so why so long in other cases?As for your blood marker test, your GP's attitude is reminiscent of the registrar who saw me when I found my second breast lump and who thought it was scar tissue. He only grudgingly gave in to my insistence that this was new and arranged a routine CT scan which eventually proved that I was right and he was wrong. Sadly doctors are not infallible and the system can let us down too.

Janice, I am so pleased all is well with you, and understand how concerning it is when something seems to be wrong - yet again! I have had a similar week, probably nothing is wrong but enough little niggling symptoms to prompt a request for scans and blood tests. Nothing shown in scans - had to wait overnight to get the results. Still awaiting the blood results. Reading with interest all the above comments, most of the issues are similar in Australia, but it is hard to make an exact comparison. The government has been trying to exert pressure on GPs to reduce both testing and referrals, which can be worrying. Last year it took me 3 months of consultations and requests to convince my GP I needed further investigation, when I had a huge polyp in the uterus. It is an issue of concern as we age and particularly post-cancer. So glad you are examen normal - now enjoy the bliss that is France! xox

Thank goodness all is well. There may still be a mystery about the cause of your pain but all the nasty things have been ruled out. I have always found the NHS to be good at that, too, but everyone I speak to in France has a much better experience than in the UK. As you say, they get there quicker.There are thousands of really good people working in the NHS but getting to see the right one is ridiculously difficult. The process of trying all the cheap and easy tests and treatments first to save money actually wastes time and costs more in the end. If they just got on with the job instead of employing delaying tactics it would be more like the French system.My father recently spent a week in hospital and for the first four days he had no treatment or tests at all, he might just have well been in a hotel. They admitted him and couldn't decide what to do, which was pointless. Then it was test something one day, find out the result and order another test the next day, and so it went on. A ludicrous waste of a hospital bed.The NHS is great, but the management of it is awful. Too much time and money spent putting off the job that should be done straight away.

Yes, something is not right..... it seems that there are just not enough people employed to deal with what faces them on a day to day basis. The NHS has been amazing for me, but thinking that with more investment it could be so much more efficient is frustrating, as we see more and more cuts made. The current news about the deficit is frightening.

I am so glad that there was not a serious problem...when you have had one health scare you are on tenterhooks in case what you are undergoing should be the herald of more problems.I've been a long time away from the NHS but my mother has had super treatment - her GP comes out on the day he is called; after a fall she was admitted to hospital as a precaution and checked thoroughly...she had hip and knee replacements when in her nineties to keep her independent.When in France we had a super G.P. (Spanish) who fought my husband's corner against fairly uncaring specialists who seemed to wish to use him as a guinea pig....yes, blood test, X rays etc...came back rapidly, but the essential long term treatment was hard to obtain.I broke my leg and had a botch job done by the local hospital...it pains me to this day....yes, the district nurse could have come to give me the anti phlebitis jabs while I was in plaster but it was easier to do it myself...apart from my shock at the pittance she was paid for so doing.I think that the problems of the NHS are brought about deliberately in order to make privatisation an acceptable option...the last government here in Costa Rica started a similar programme and the people were out in the streets in protest. I wish the British would wake up to what is happening....

I fear you are right. The current news about the massive deficit, being as much as the whole of last year, just for the first quarter of this year, makes me very suspicious....how convenient that the current funding model is not working....so that other models will have to be considered.....ooohhh, what a surprise, more and more privatisation. Hope your mother is still enjoying good health, and that those Drs still visit when needed. x

Hi Janice,Excellent news about your health but also the state of the French health care system. You must have been so worried, and relieved at the speedy nature of the tests and consultations to allay your fears.I'm not sure why the UK isn't always able to replicate the efficiency you encountered in France, given how hard so many people within the NHS work.Your short holiday in Spain has looked wonderful and a real treat for you both. I'm sure your family will be so pleased to have you back in the UK fit and well, even though leaving the stunning Caunes will be a wrench. Xx

Leaving Caunes is always a wrench, but luckily I can look forward to the Yorkshire bit of our year, and know I will enjoy it....and Caunes will be here next year....and according to my examen normal, I should be too !!!! x

I read your post, Janice, and was glad to hear all was OK - and that you heard so quickly too. I have mixed feelings about the health care in Spain. It is good, it is state funded but it depends on what is wrong with you as to how soon you will be seen. My tinnitus problem was referred to the specialist within the week. I went, had my ears inspected and my hearing tested and then very dismissively told there was nothing obviously wrong and no solution, cure or treatment for tinnitus....go away. NEXT! Some of the specialists are incredibly rude and arrogant and I've seen a lot as I go with an English woman who has Crohn's Disease and needs to see many different doctors. The family doctors are also very variable. Mine is OK, Mateo's is wonderful - Sam's was an absolute arsehole...can't think of another word. As we are resident, we don't pay. I don't think it works quite as well here for the non-resident UK patients...not unless they can speak very good Spanish, which few can. I won't get started on the countless other thoughts I have just now - I meant to leave a comment when I first read the post but I was on my phone and had no glasses with me....rendering phone-typing impossible!! I agree with Maria, you have been looking so incredibly well and relaxed and gorgeous on all your recent photos, there can be no doubt that you are absolutely fine!Axxx

About Me

In September 2011 after years of staring longingly in French estate agency windows ..... we finally bought a house 20 minutes drive from Carcassonne, intending to divide our lives between Hebden Bridge and Caunes Minervois. Things haven't worked out quite as we imagined, as I was diagnosed with cancer last October. Following surgery and follow up treatment we are now working hard on my recovery, and are spending time in the two places we love.... Caunes Minervois and Hebden Bridge